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Machine Learning Improves Survival Prediction after Allogeneic Hematopoietic Cell Transplantation

April 3 @ 2:00 pm 3:00 pm

Part of the Planning Workshop #1

Akshay Sharma, MBBS, MSc
St. Jude Children’s Research Hospital


Serial prognostic evaluation after allogeneic hematopoietic cell transplantation (allo-HCT) might help identify patients at high risk of lethal organ dysfunction. Current prediction algorithms based on models that do not incorporate changes to patients’ clinical condition after allo-HCT have limited predictive ability. We developed and validated a robust risk-prediction algorithm to predict short- and long-term survival after allo-HCT in pediatric patients that includes baseline biological variables and changes in the patients’ clinical status after allo-HCT. The model was developed using clinical data from children and young adults treated at a single academic quaternary-care referral center. The model was created using a randomly split training data set (70% of the cohort), internally validated (remaining 30% of the cohort) and then externally validated on patient data from another tertiary-care referral center. Repeated clinical measurements performed from 30 days before allo-HCT to 30 days afterwards were extracted from the electronic medical record and incorporated into the model to predict survival at 100 days, 1 year, and 2 years after allo-HCT. Naïve-Bayes machine learning models incorporating longitudinal data were significantly better than models constructed from baseline variables alone at predicting whether patients would be alive or deceased at the given time points. This proof-of-concept study demonstrates that unlike traditional prognostic tools that use fixed variables for risk assessment, incorporating dynamic variability using clinical and laboratory data improves the prediction of mortality in patients undergoing allo-HCT.

Bio: Akshay Sharma, MBBS, MSc is a pediatric hematologist, oncologist and transplant physician at St. Jude Children’s Research Hospital in Memphis, TN. His postdoctoral work focused on understanding the genetic regulation of fetal hemoglobin and as a physician-scientist he continues to advance that work in the form of novel gene therapy clinical trials for patients with sickle cell disease. He leads several clinical studies of genetically modified autologous and allogeneic hematopoietic cell transplant for nonmalignant hematological disorders. In addition, he is the co-chair of the CIBMTR Pediatric Cancer Working Committee and has led several projects assessing impact of factors affecting health outcomes after HCT for various blood disorders, especially in children. The goal of his clinical research is to advance cellular therapeutics for children with hematological disorders. He is passionate about improving access to these novel therapies in an equitable and patient-centered manner.